NPI | 1063943983 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0092712) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0092712) |
Enumeration Date | 2017-03-22 |
Last Update Date | 2022-06-22 |